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55 ANTIBIOTIC RESISTANCE & STEWARDSHIP Antibiotic overuse may hinder efficacy of cancer treatments, study finds By Brian Zimmerman T he overuse of antibiotics may adversely affect cancer treatments, according to a study published in the journal Oncotarget. For the study, researchers assessed how antibiotic overuse influenced the efficacy of various cancer treatments in lab animals. Antibiotic use immediately influences our gut bacteria, rendering us resistant to certain antibiotic therapies. Antibiotics' influence on gut bacteria may also adversely affect how our body activates T cells, which are essential to some oncology therapies. Researchers found in lab animals altered in- testinal microbiota reduces the ability of the chemotherapy treatment cyclophosphamide (CTX) to combat sarcoma. "It is clear in animal models that if you wipe out the intestinal microbiota, like you do with antibiotics, it will attenuate the che- motherapy efficacy," said Gang Zhou, PhD, immunologist at the Georgia Cancer Center in Augusta and one of the study's authors. "ere is also emerging clinical evidence showing that for CTX-based chemotherapy, some patients who also get antibiotics for a longer period of time, seem to have less optimal outcomes." n Nearly 70% of antibiotic prescriptions for sinusitis exceed recommended durations By Anuja Vaidya A study published in JAMA Internal Medicine examined antibiotic courses prescribed for acute sinus infections. Researchers used the 2016 National Disease and Therapeutic Index to investigate 3.7 million visits to physicians where antibiotics were prescribed for acute sinusitis. They grouped the antibiotics as penicillins, tet- racyclines, fluoroquinolones, cephalosporins, azithro- mycin or other. They noted treatment duration in days. The Infectious Diseases Society of America recommends five to seven days of antibiotic treatment for uncompli- cated cases. However, the study shows 69.6 percent of antibiotic therapies for sinusitis were prescribed for 10 days or longer. Additionally, when prescriptions for azithromycin were excluded, 91.5 percent of antibiotic courses were pre- scribed for 10 days or longer. n Study: Antibiotics still overprescribed in outpatient settings, despite efforts to improve prescribing practices By Brian Zimmerman A nnual outpatient antibiotic prescription rates remained virtually unchanged from 2013 through 2015, despite national efforts to curb unnecessary prescriptions due to the mounting issue of antibiotic resistance, according to a study published in the journal Infection Control & Hospital Epidemiology. For the study, researchers examined administrative claims information compiled between 2013-15 in Ex- press Scripts Holding Co.'s member database. Research- ers found members filled 98 million antibiotic prescrip- tions over the three-year period. The average number of prescriptions per 1,000 members ranged from 830 to 849 annually. Researchers identified a decrease in prescription rates between 2013 and 2014, followed by an increase in 2015. The team identified the top five most-prescribed antibiotics as azithromycin, amoxicillin, amoxicillin/clavulanate, ciprofloxacin and cephalexin. "If quality improvement guidelines were sufficient to improve antibiotic prescribing practices, then we would have expected to see an overall decrease in antibiotic pre- scribing rates over time," said lead study author Michael Durkin, MD, assistant professor of medicine at Washing- ton University School of Medicine in St. Louis. "A more rigorous framework and greater investment of resources is needed to substantially improve outpatient antibiotic prescribing rates, helping to combat antibiotic resistance and improve patient safety." n